CVderm, Institute for Health Services Research in Dermatology and Nursing - IVDP, University Medical Center Hamburg-Eppendorf, Germany.
J Dtsch Dermatol Ges. 2010 Sep;8(9):674-80. doi: 10.1111/j.1610-0387.2010.07437.x. Epub 2010 May 31.
On July 1st 2008, community skin cancer screening (cSCS) was established in routine care of the German statutory health insurances (SHI). This study aimed at gathering preliminary data on the impact of community SCS on health care provision in German dermatology practices.
Standardized questionnaires were sent to about 2,000 German dermatology practices. Data were analyzed descriptively and with bivariate tests.
In total, 693 (34.7%) questionnaires were returned. Each practice performed an average of 354 SCS per quarter, the mean payment being euro 21.50. About 78% named an increase in SCS with an average increase of 36.7%. About 54% of practices performed SCS under SHI payment combined with individual health services paid by the patients ("IGeL"), 38% only as SHI and 8% exclusively as "IGeL". In 85% of practices, the number of surgical procedures had increased since the start of community SCS. 40% had an increase in drug prescriptions related to SCS. 32% were satisfied with SCS, while 40% were unsatisfied. 29 % would prefer SCS only as covered by SHI, 29% only as IGeL, and 42% in a combined fashion. 70% regarded the quality of health care of patients with skin cancer in Germany better since the introduction of cSCS.
Dermatologists in Germany have mainly accepted their role in providing skin cancer as standard care covered by SCS. The regulatory and economic conditions for this need further improvement.
2008 年 7 月 1 日，德国法定健康保险开始将社区皮肤癌筛查纳入常规服务。本研究旨在收集社区皮肤癌筛查对德国皮肤科实践中医疗服务提供的初步影响数据。
向约 2000 家德国皮肤科诊所发送了标准化问卷。对数据进行了描述性和双变量检验分析。
共收到 693 份（34.7%）问卷。每家诊所每季度平均进行 354 次 SCS，平均支付额为 21.50 欧元。约 78%的诊所报告 SCS 有所增加，平均增加 36.7%。约 54%的诊所按照 SHI 支付与患者自费的“IGeL”相结合的方式进行 SCS，38%仅按照 SHI 进行，8%仅按照“IGeL”进行。在开展社区 SCS 后，85%的诊所进行的手术数量有所增加。40%的诊所开具的与 SCS 相关的药物处方有所增加。32%的诊所对 SCS 感到满意，而 40%的诊所不满意。29%的诊所希望 SCS 仅由 SHI 覆盖，29%的诊所希望仅由 IGeL 覆盖，42%的诊所希望以组合方式覆盖。70%的诊所认为自开展 cSCS 以来，德国皮肤癌患者的医疗质量有所提高。
德国皮肤科医生主要接受了他们在提供皮肤癌筛查服务方面的角色，作为 SCS 覆盖的标准护理。这方面的监管和经济条件需要进一步改善。
